| NPI | 1265986673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246X00000X Specialist/Technologist Cardiovascular (Licence: MD 32685) |
| Additional Taxonomies | 2471S1302X Radiologic Technologist Sonography |
| 2471V0105X Radiologic Technologist Vascular Sonography | |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2016-08-15 |